Down To Earth

Editorial. Sunita Narain.
IX.X.XV

Dengue, Another Climate
Alert

by Sunita
Narain

What does farmer’s
despair over crop failure have in common with
dengue fever, which is ravaging Delhi and other
cities of India? Seemingly nothing. But dig a
little deeper and you will find that in both cases
variable and erratic weather is at the root of
these tragic events. There is another connection:
lack of governmental policy, action and, quite
frankly, callous neglect that has made both events
even more horrific and painful.

Last fortnight, I wrote about the
killing fields of India, where unseasonal, extreme
and deficient rainfall had driven farmers to
despair. It is clear that this variable weather is
not a freak event, but points to the changes that
are beginning to influence our monsoon lifeline.
It is equally clear that current policies
exacerbate agrarian distress. It is farmers who
pay with their lives.

This fortnight, it is vector-borne
disease dengue that is taking lives. The most
heartbreaking incident was of a child whom
hospital after hospital in capital city Delhi
refused admission. Devastated parents jumped off
their roof. They could not face life anymore. Many
more cases in Delhi and across India have emerged.
One explanation for the virulence this year is
that the mosquito has a four-year cycle, and this
is its peak year. Another explanation is that it
is a different serotype of the dengue virus; or
that Aedes aegypti and Aedes albopictus, the two
mosquito species that transmit the dengue virus,
have mutated and become more
harmful.

But these suppositions do not add up to
explain the extent of damage this mosquito has
done this year. Explanation for that lies
somewhere else. One is this year’s strange
weather. There has been periodic rain, which is
followed by days of intense heat. Down To Earth
reports about global studies that point to how
risk of dengue increases in such
situations.

Unseasonal rain in February and March
not only damaged crops, but also prolonged the
season for mosquitoes. Climate changes will make
the environment conducive to mosquito breeding,
show all models on impacts. But we just do not
listen. It is time we stopped debating the C word.
Climate change is here in terms of weird weather
events and its impacts will only grow as the
runaway temperature, caused by our fossil fuel
addiction, continues to spiral out of
control.

This is still only one part of our
challenge. The other reason behind dengue’s
deadliness is sheer mismanagement of health
services and shockingly bad governance. In Delhi,
the current elected state government is locked in
a war with the other elected national government.
In this game of one upmanship the casualty is
governance. Such environment is not ideal for any
real developmental action. What thrives instead is
meaningless politics and a highly polarised
discourse.

In all this, our health services are
neglected. We have not invested in building public
infrastructure to provide basic and now tertiary
services. It is the most odiously oft-repeated
statement that India’s investment in health
services remains one of the lowest in the world.
The assumption is that the government does not
need to do anything; instead as people get rich,
private health services will spread and more than
adequately fill the void. If people cannot pay,
then insurance companies will step in and this
will certainly fill the void. But as the dengue
crisis shows, without public infrastructure, or at
the very least public regulation to keep costs in
check, people will die. Today, to manage this
public health crisis, the government has capped
the price of laboratory tests and vacated beds in
public hospitals—sent other equally ill
people home—to take care of the dengue
epidemic. This is no way to go about dealing with
dengue.

All this will not work if we do not
prevent diseases—in the case of dengue,
clean our environment to make sure that whatever
the adverse weather changes the mosquito does not
breed. There is some evidence that dengue
mosquito, which earlier bred only in clean water
is adapting rapidly to our dirty
environment.

All this means, once again, that we
cannot have piles or ponds of garbage and polluted
stagnant water. Our municipal services cannot
fail. We cannot fail. And it can be done. Many
years ago, our experiments with bio-vector
control—in Puducherry and later in Kheda
district of Gujarat—showed a dramatic
reduction in vector-borne diseases. In these
cases, what was done was aggressive cleaning of
the environment to make sure there was no stagnant
water in drains and use of fish larvae to
eradicate the mosquito. Basic
stuff.

Climate change has only magnified our
already existing risks, whether in the case of
farmers or in the case of dengue. The growing
impacts of climate change in terms of weird
weather tell us that we do not have the luxury of
time anymore. We need to get our act together, and
act. Fast.